NCCN Guidelines for Patients® | Melanoma - page 59

NCCN Guidelines for Patients
Melanoma, Version 1.2014
include imiquimod cream and radiation therapy.
(Read Part 4 on page 34 for details on each type of
For thicker melanomas, you may also have a
sentinel lymph node biopsy
during surgery to
remove the tumor. A sentinel lymph node biopsy
removes the sentinel lymph node to test for cancer
cells. The sentinel lymph node is the first lymph
node to which cancer cells will likely spread from
the primary tumor. If the biopsy finds cancer in the
sentinel lymph node, the melanoma stage will be
moved up (upstaged) to pathologic stage III. In this
case, you will be treated for stage III melanoma
instead of stage I or II. (Read Part 3 on page 26 for
details and criteria of melanoma stages.)
Adjuvant treatment
For stage 0 and IA tumors and most stage
IB tumors,
adjuvant treatment after surgery isn’t
needed. Instead, you will begin observation—a
period of scheduled follow-up testing to watch for
cancer spread (metastasis) or return (recurrence).
While most people with stage IB and IIA melanoma
are also watched closely for recurrence, a second
option is to receive adjuvant treatment within a clinical
trial. A clinical trial is a type of research that studies
a treatment to assess how safe it is and how well it
For some people with stage IIB or IIC melanoma,
a third option is to receive interferon alfa. Read Part 4
on page 34 for details on each type of treatment.
Next steps:
For stage 0, I, or II melanoma, see
Chart 5.2.3 for recommended follow-
up tests after primary or adjuvant
treatment. For pathologic stage III
melanoma that was upstaged based
on the sentinel lymph node biopsy, see
Part 5.3.
Treatment guide
In situ and local melanoma
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